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Participation and detection rates by age and sex for colonoscopy versus fecal immunochemical testing in colorectal cancer screening |
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| Authors: | Dolores Salas Mercedes Vanaclocha Josefa Ibáñez Ana Molina-Barceló Vicente Hernández Joaquín Cubiella Raquel Zubizarreta Montserrat Andreu Cristina Hernández Francisco Pérez-Riquelme José Cruzado Fernando Carballo Luis Bujanda Cristina Sarasqueta Isabel Portillo Mariola de la Vega-Prieto Juan Diego Morillas Vicente Valentín Ángel Lanas Enrique Quintero Antoni Castells |
| Institution: | 1. General Directorate Public Health, Avda. Calatu?a, 21, 46020, Valencia, Spain 2. Centre for Public Health Research (CSISP), FISABIO, Valencia, Spain 3. Department of Gastroenterology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain 4. Department of Gastroenterology, Complexo Hospitalario Universitario de Ourense, Ourense, Spain 5. Directorate for Innovation and Management of Public Health, Santiago de Compostela, Spain 6. Department of Gastroenterology, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), Pompeu Fabra University, Barcelona, Catalonia, Spain 7. Department of Epidemiology and Evaluation, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain 8. General Directorate Public Health, Murcia, Murcia Región, Spain 9. Institute of Bio-health Research of Murcia (IMIB), Murcia, Murcia Región, Spain 10. Department of Gastroenterology, Virgen de la Arrixaca Universitary Hospital, Murcia, Spain 11. Department of Gastroenterology, Donostia Hospital-Instituto Biodonostia, CIBERehd, University of Basque Country (UPV/EHU), San Sebastián, Spain 12. Donostia Hospital-Instituto Biodonostia, REDISSEC, San Sebastián, Spain 13. Basque Health Service, Basque Country, Spain 14. General Directorate of Health Care Programmes, Canary Islands Health Service, Santa Cruz, Spain 15. Department of Gastroenterology, 12 de Octubre Hospital, Madrid, Spain 16. Regional Office for Oncology Coordination, Consejería de Sanidad, Madrid, Spain 17. Department of Gastroenterology, IIS Aragón, CIBERehd, University of Zaragoza, Zaragoza, Spain 18. Department of Gastroenterology, Canarias Universitary Hospital, Tenerife, Spain 19. Department of Gastroenterology, Hospital Clínic, CIBERehd, Institut d’Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain |
| Abstract: | PurposeTo compare two strategies for colorectal cancer screening: one-time colonoscopy versus fecal immunochemical testing (FIT) (and colonoscopy for positive) every 2 years, in order to determine which strategy provides the highest participation and detection rates in groups of sex and age.MethodsThis analysis was performed with data from the first screening round within the COLONPREV study, a population-based, multicenter, nationwide trial carried out in Spain. Several logistic regression models were applied to identify the influence of the screening test on participation rates and detection of proximal and distal neoplasms, as well to identify the influence of age and sex: women aged 50–59 years, women aged 60–69 years, men aged 50–59 years, and men aged 60–69 years.ResultsParticipation was higher in women than in men, especially among women aged 50–59 years (25.91 % for colonoscopy and 35.81 % for FIT). Crossover from colonoscopy to FIT was higher among women than men, especially among those aged 60–69 years (30.37 %). In general, detection of any neoplasm and advanced adenoma was higher with colonoscopy than with FIT, but no significant differences were found between the two strategies for colorectal cancer detection. Detection of advanced adenoma in both arms was lower in women specifically in women aged 50–59 years (OR 0.31; 95 % CI 0.25–0.38) than in men aged 60–69 years]. Women aged 50–59 years in the colonoscopy arm had a higher probability of detection of advanced adenoma (OR 4.49; 95 % CI 3.18–6.35), as well as of detection of neoplasms in proximal and distal locations (proximal OR 19.34; 95 % CI 12.07–31.00; distal OR 11.04; 95 % CI 8.13–15.01) than women of the same age in the FIT arm. These differences were also observed in the remaining groups but to a lesser extent.ConclusionWomen were more likely to participate in a FIT-based strategy, especially those aged 50–59 years. The likelihood of detection of any neoplasm was higher in the colonoscopy arm for all the population groups studied, especially in women aged 50–59 years. Distinct population groups should be informed of the benefits of each screening strategy so that they may take informed decisions. |
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